The impact of virtual care on drug prescribing practices: A scoping review

Upon the emergence of COVID-19, virtual alternatives to in-person care developed quickly to meet the need of physicians to maintain medical distancing from patients. Virtual care has since become a mainstay in the landscape of primary care with many physicians providing both virtual and in-person visit options within their practice. However, due to its rapid development, questions have been raised regarding the quality of virtual care compared to its in-person alternative, particularly in terms of prescribing appropriateness. Thus, we examined whether global prescribing patterns differed between virtual and in-person physician visits following the onset of the COVID-19 pandemic. We conducted a scoping review of global literature with narrative synthesis to assess whether and how prescribing patterns differed between virtual and in-person care. This review revealed mixed findings, with the majority of studies reporting no significant difference in medication or antibiotic prescribing rates. Some weak evidence suggested virtual care may be associated with greater adherence to clinical guidelines. However, the predominance of United States based studies and methodological limitations precluded strong conclusions, particularly for the Canadian context. Our scoping review found no consensus in the global literature on how prescribing patterns differ between virtual and in-person care. The methodological weaknesses and limited generalizability of the existing body of evidence highlights the need for further high-quality research in a broader range of settings.